Fetal alcohol syndrome (FAS) is observed in infants delivered to women who consume large amounts of alcohol in pregnancy. Prenatal alcohol exposure has also been related to developmental deficits and other alcohol related birth defects in the absence of the full syndrome. It has been suggested that fetal alcohol effects may account for a significant portion of previously unexplained neurobehavioral developmental deficits; nevertheless, the few prospective studies reported do not provide sufficient support for this highly important statement. Whether the exposure is frequent, or acute, as in binge drinking episodes, is another major question. This proposal provides a unique opportunity to obtain answers to these questions. Included is the final, and probably the most important, assessment of a cohort of 359 children for whom we have extensive data, carefully collected, starting with the first maternal antenatal visit. Of these, 176 were delivered to women with a history of alcohol abuse and 183 to matched controls. Detailed records of antenatal alcohol use and other relevant pregnancy conditions constitute an important part of the database. Developmental outcome measures were collected at birth and at ages six months, one year, and two years. Data collection at age three years is now underway. Home examinations by trained examiners have enabled us to retain 77% of the original sample. An examination at age four years, nine months, is scheduled to assess persistence of effects into the preschool period. The evaluations include measures of growth, intelligence, communication skills, psychomotor skills, behavior ratings and reaction time. Relevant covariate data have been collected for entry into the analyses. The possibility of interactive influences of home stimulation and excessive parental alcohol use during the caretaking years is being appraised. Data analysis plans are illustrated by results demonstrating a strong significant association of neonatal anomalies and first trimester drinking, for infants delivered to women with histories of alcohol abuse.